Millions of Older Adults Take Risks With Blood Pressure Meds

About 5 million Medicare Part D enrollees age 65 and up aren’t taking their blood pressure medication as directed, according to a new report released from the Centers for Disease Control and Prevention. They’re skipping doses, have stopped taking their pills, or are not filling their prescriptions in the first place.

That’s a problem, because high blood pressure, or hypertension, is a leading cause of death and disability. It’s often called the “silent killer” because it typically has no signs or symptoms until it has done significant damage to the heart and arteries. Besides heart attack, stroke, heart failure, and kidney disease, uncontrolled hypertension can lead to cognitive decline and dementia.

About 70 percent of adults over the age of 65 in the U.S. have high blood pressure, and only about half have their condition under control (defined as a reading under 140/90 mmHg). One in four are not receiving any treatment.

The ‘stroke belt’

Medicare Part D is a federal program that helps Medicare beneficiaries with the costs of prescription drugs and prescription drug insurance premiums. The CDC report found that among people with Medicare Part D health insurance, those living in the Southern states, or “stroke belt” of the U.S., were least likely to take their blood pressure medication as prescribed. Patients living in Minnesota, North Dakota, and Wisconsin were most likely to take their meds. Ethnic groups less likely to take blood pressure meds included American Indians/Alaskan natives, African-Americans, and Hispanics.

Not following medication instructions—called non-compliance or non-adherence—is a serious problem that can lead to a number of short- and long-term health problems. The American Heart Association estimates that non-compliance is associated with about 125,000 deaths, and nearly $300 billion in additional healthcare costs for doctor and emergency room visits, medical tests, and hospitalizations each year in the United States.

Improving compliance

With the repercussions of not taking blood pressure medicine so severe, why aren’t more people taking their meds? According to the AHA, patients may simply forget to take their medicine, may have doubts about whether the drug is working or truly needed, or may experience adverse side effects. For an increasing number of patients, the rising cost of prescription drugs is an important factor.

“While the Medicare prescription drug program has increased the affordability and accessibility of prescription drugs, more can be done to encourage Medicare beneficiaries to take their medications as directed,” said Sean Cavanaugh, director of the Center for Medicare, in a statement. “Medicare will continue to work with prescription drug plans to educate enrollees about the importance of taking their blood pressure medications as prescribed so that they can lower their risk for heart disease and stroke.”

Treatment for high blood pressure also includes lifestyle measures to reduce the risk for serious, possibly life-threatening, complications.

Learn more about How Often to See a Doctor for Hypertension and The Drugs Used to Treat High Blood Pressure.